Individual provider Active NPI

Kenneth Alan Murphy, D.D.S.

  • General Practice Dentistry
  • Atlanta, GA
National Provider Identifier
1982623344
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN010966 Issued in GA
Practice address
5555 Peachtree Dunwoody Rd NE
Suite 255 the Medical Quarters
Atlanta, GA 30342-1703
Phone
(404) 255-8555
Fax
(404) 255-6555
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN010966 GA Primary

Addresses

Primary practice location

5555 Peachtree Dunwoody Rd NE
Suite 255 the Medical Quarters
Atlanta, GA 30342-1703

Mailing address

5555 Peachtree Dunwoody Rd NE
Suite 255 the Medical Quarters
Atlanta, GA 30342-1703
Phone (404) 255-8555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150609002809 GA Order and Referring Only - Other (Non-Physician) 5496076994

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN010966GAMDGeneral Practice Dentistry

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982623344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 PEACHTREE DUNWOODY RD NE",
            "address_2": "SUITE 255 THE MEDICAL QUARTERS",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421703",
            "telephone_number": "404-255-8555",
            "fax_number": "404-255-6555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 PEACHTREE DUNWOODY RD NE",
            "address_2": "SUITE 255 THE MEDICAL QUARTERS",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421703",
            "telephone_number": "404-255-8555",
            "fax_number": "404-255-6555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURPHY",
        "first_name": "KENNETH",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN010966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.